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What Do Med Students Need To Know About EMRs?

Posted on August 16, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Recently, I was asked to write an introduction to EMRs, focusing on what medical students needed to know in preparation for their future careers. This actually turned out to be a very interesting exercise, as it called for balancing history with the future, challenges with benefits and predictable future developments with some very interesting possibilities. Put another way, the exercise reminded me that any attempt to “explain” EMR technology calls for some fancy dancing.

Here’s some of the questions I tackled:

  • Do future doctors need to know more about how EMRs function today, or how they should probably function to support increasingly important patient management approaches like population health?
  • Do med students need to understand major technical discussions – such as the benefits of FHIR or how to wrangle Big Data – to perform as doctors? If so, how much detail is helpful?
  • How important is it to prepare med students to understand the role of data generated outside of traditional patient care settings, such as wearables data, remote monitoring and telemedicine consults? What do they need to know to prepare for the gradual integration of such data?
  • What skills, attitudes and practices will help physician trainees make the best use of EMRs and ancillary systems? And how should they obtain that knowledge?

These questions are thornier than they may appear at first glance, in part because there no hard-and-fast standards in place as to how doctors who’ve never run a practice on paper charts should conduct themselves. While there have been endless discussions about how to help doctors adopt an EMR for the first time, or switch from one to the other, I’m not aware of a mature set of best practices available to med students on how next-gen, health IT-assisted practices should function.

Certainly, offering med school trainees a look at the history of EMRs makes sense, as understanding the reasons early innovators developed the first systems offers some interesting insights. And introducing soon-to-be physicians to the benefits of wearable or remote monitoring data makes sense. Physicians will almost certainly improve the care they deliver by understanding EMRs then, now and their near-term evolution as data sources.

On the other hand, I’m not sure it makes sense to indoctrinate med students in today’s take on evolving topics like population health management or interoperability via FHIR. These paradigms are evolving so rapidly that pinning down a set of teachable ideas may be a disservice to these students.

Morever, telling students how to think about EMRs, or articulating what skills are needed to manage them, might actually be a bad idea. I’m optimistic enough to think that now that the initial adoption frenzy funded by HITECH is over, EMRs will become far more usable and physician-shapeable over the next few years, allowing new docs to adapt the tool to them rather than adapt to the tool.

All that being said, educating med students on EMRs and health IT ancillary tools is a great idea. I just hope that such training encourages them to keep learning well after the training is over.

Cutting Down On EMR Implementation Struggles

Posted on August 14, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

In blogs like this one, we spend a lot of time talking about the frustrations doctors face when adapting to use of an EMR. But what if there were ways EMR implementations could be less painful for doctors (and their staff)? According to Dike Drummond, MD, there’s three major ways to minimize the pain and improve the process of putting an EMR in place in a medical practice.

* Change your attitude

According to Drummond, doctors often start out hating EMR technology and resisting the idea it could ever be helpful. “We treat the computer and the programs as if they rose from the very fires of hell to torment us,” Drummond notes. As a result, physicians fail to embrace the technology and never learn how to use it well, leading to more unhappiness, he suggests.

Instead of being angry and frustrated, set yourself a goal of becoming a power user, Drummond advises his colleagues. Take all vendor training twice, and have your nurse and receptionist do so too; customize your EMR to offer the most personalized and elegant experience possible, including automating any repeat keystrokes; and sit and watch over the shoulder of well-versed colleagues to see what existing power users do. “Just one tip from a power user colleague can make a huge difference in each patient encounter,” he says.

* Don’t force paper and EMR to compete

Too often, medical practices overlay new documentation requirements for their EMR on top of their paper chart patient flow process, and results are usually pretty ugly, Drummond warns. Doing so “sets up a Death Match between your old flow systems and your new EHR,” he says.

The better strategy is find ways to integrate the two processes, he  suggests. It’s much better to find ways to alter the way you see patients so the EMR documentation gets built into your patient flow.  Refusing to accept this makes no sense, he argues.

Leverage your team

Doctors are used to being the one who steps out in front and leads the team, but in this case, it’s important for doctors to dig in and take advantage of the insights their team can offer.  Doctors should get everyone’s ideas on how to refine workflow through powerful brainstorming sessions.

To further the process, Drummond recommends doctors ask open-ended questions such as the following:

~  What do you see me doing that I can stop – or  you can do better?
~  What ideas do you have on how we can do things differently to make documentation easier?
~  How can we share the charting activities more effectively?

Drummond’s points are well-taken, but I’d go even further. Doctors don’t need to just adapt to an EMR and tailor it to their needs, they have to embrace digital tools — from smartphones and tablets to patient portals and e-mail — if they’re going to survive the next wave of medical practice.  But for starters, it certainly makes sense to stop hating on EMRs and learn how to make them work as a supportive tool. The advent of EMRs is inevitable, so why fight?

Cutting EMR Training Budget Can Create Serious Problems

Posted on April 17, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Not long ago, American Medical News ran an article on training up medical practice staffers for EMR use. The piece concluded that while practices may save some bucks on the front end, they generally end up regretting it later.  An anecdote from the piece:

Nine months after All Island Gastroenterology and Liver Associates in Malverne, N.Y., went live with its electronic medical record system, practice administrator Michaela Faella realized things had not gone as smoothly as planned.

Even though the staff had used other health information technology systems for many years and considered itself tech-savvy, it had taken everyone six months to learn how to use the new EMR system. Several months later, the staff still had not become proficient at it.

The problem was not with the staff, but that the practice cut training short to save time and money. “Training was not placed high on the priority list, and we paid the price for it,” Faella said.

As the piece notes, many practices assume that the training bundled into the cost of their new EMR will meet their needs, and find out to their regret that this isn’t the case.  (In fact, I’d argue that this is more the rule than the exception, based on anecdotes I hear in the field and in conversations with physicians.)

A consultant quoted in the piece suggests that practices should consider three main issues when planning for training:

1) How much data they’ll be dealing with, which can vary greatly depending on whether all data is imported in advance or done patient by patient

2) Whether the practice will be integrating new systems into the EMR, such as e-prescribing, or conversely, adding an EMR to existing systems

3) Whether using the EMR will call for using new hardware such as tablet computers

Personally, I’m not satisfied by that list at all.

What about, first and foremost, assessing the staff’s existing skills more precisely, walking staffers through the various layers of the EMR on a daily basis, forming teams of superusers within the organization to help the less skilled and taking steps to be sure EMR problems don’t interrupt critical functions (a backup/workaround plan for the short term)?

What do you think?  Does the list above cover the critical EMR practice integration issues?  Am I just being testy?

101 Tips to Make Your EMR and EHR More Useful – EHR Tips 1-5

Posted on January 24, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Time for the next entry covering Shawn Riley’s list of 101 Tips to Make your EMR and EHR More Useful. I can’t believe that this is the last post in the series. I think it’s been a good series chalk full of good tips for those looking at implementing an EHR in their office. I’d love to hear what people thought and if they’d like me to do more series like this one. Now for the final 5 EMR tips.

5. Automatic trending helps all over the place – A picture is worth a thousand words and this is never more true than when we’re talking about trending. Make sure your EHR software can quickly take a set of results and/or data points and graph them over time.

4. Keep training over and over – Are you ever done learning software? The answer for those using an EMR is no. Part of this has to do with the vast volume of options that are available in EMR software. However, the training doesn’t necessarily have to come from formal training sessions. Much of the training can also come by facilitating interaction and discussion about how your users use the software. By talking to each other, they can often learn from their peers better ways to use the software.

3. Infrastructure is key to performance – I love when people say “My EMR is Slow” cause it’s such a general statement that could have so many possible meanings. Regardless of the cause of slowness, the EMR is going to get the blame. For those wanting to dig in to the EMR slowness issue, you can read my pretty comprehensive post about causes of EMR slowness. I think you’ll also enjoy some of the responses to that EMR slowness post.

Infrastructure really matters when someone is using an EMR all day every day. There’s no better way to kill someone’s desire to use an EMR than to have it be slow (regardless of who’s responsible).

2. Quit pulling charts as soon as possible – I think this tip should be done with some caution. In certain specialties the past chart history matters much more than in others. Although, it’s worth carefully considering how often you really look through the past paper chart in a visit. You might be surprised how rare it is that you really need the past paper chart. If that’s the case, consider only pulling the chart when it’s needed. If you only find yourself looking through the past paper chart for 2 or 3 key items, then just have someone get those 2 or 3 items put into the EMR ahead of time. Then, it will save you having to switch back and forth. Plus, then it’s there for the next time the patient visits.

1. Crap process + Technology = Fast Crap – Perfect way to end 101 EMR and EHR Tips! I like to describe technology as the great magnifier. The challenge is that it will magnify both the good and bad elements of your processes. Fix the process before you apply the technology.

If you want to see my analysis of the other 101 EMR and EHR tips, you can find them all at the following link: 101 EMR and EHR tips analysis.

No EHR Training Needed

Posted on October 6, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Anne Zieger over on EHR Outlook just posted an article talking about the need of training on an EHR. In the article, she quotes Dr. Bertman, CEO of EMR company Amazing Charts (Full Disclosure: They’re a sponsor of this site). Here’s one excerpt from the article:

According to Dr Jonathan Bertman, if you need extensive training to use an EHR, you shouldn’t buy it. “Doctors know how to be doctors,” he says. “They shouldn’t have to be trained to be software technicians – if they need training than it’s not a good thing.”

Here was my response in the comments of the article (and a little additional commentary for this post):
I have a feeling Dr. Bertman and I agree about training, but I think it’s over the top for him to say, “if they need training than it’s not a good thing.” Certainly many EHR software vendors require far too much training. I think that’s the point he’s trying to make and I agree 100%. However, the reality is that there are a whole lot of people that get training even on Office. In fact, there’s a whole entire industry around training on Office products. So, EHR is going to have training as well.

Another excerpt from the article:

“Compare them to Microsoft Office,” Dr. Bertman suggests. “It’s a powerful tool, but you usually don’t need special training to use it. An EHR is not more complicated than Office, and that’s how we should be looking at them.”

I’d generally disagree that an EHR is not more complicated than Office. The reality is that what you want to do in an EHR is more complicated than Office. Sure, if all I want to do is type a little bit and maybe click bold, then I’m fine. Most EHR you don’t need any training to login, browse their appointment grid, browse patients, and even create notes.

The reason for the EHR training that’s out there isn’t for these simple features. It’s for the more advanced features like is done in most Office trainings. I could be wrong, but I believe Dr. Bertman generally agrees with me on this, but it wasn’t expressed in a short quote from him.

One other interesting point is that I think a lot of people call it EHR training when in fact it’s about EHR workflow planning and training. You’re a brave person to implement an EHR without planning out your current workflows and how they’ll map to an EHR workflow. I often see this workflow planning and training covered under the broad definition of EHR training.

101 Tips to Make Your EMR and EHR More Useful – EHR Tips 91-95

Posted on July 29, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Time for the second entry covering Shawn Riley’s list of 101 Tips to Make your EMR and EHR More Useful. I hope you’re enjoying the series.

95. Background check the vendor’s support team
This is such great advice. You’re guaranteed to have to call your EHR’s support number. You want to know what kind of answer you get. Certainly this can be learned by asking current clients of the EHR vendor. Although, don’t just ask the clients the EHR vendor gives you. Also, be sure to call other users of that EHR system to understand what kind of support they get when they have an issue.

Online forums are also a great place to learn about support. Just be aware that online you’re likely only going to read about the best and worst experiences that people have had with an EHR vendor. Of course, you can also always just give their support number a call and see what happens. Cold calling their support could teach you a lot about the type of service they provide.

94. Ask how the vendor ensures disaster recovery and business continuity
This is particularly important when you’re dealing with a SaaS EHR vendor. Don’t be shy asking them for details of how they’re doing this. In fact, if I were an EHR vendor I’d have a nice detailed explanation of how we’re doing it. If they’re doing it right, they’ll be happy to talk through the details.

If you’re considering a client server based EHR software, then some of this will fall to you and your IT team. However, your IT team can often only implement certain disaster recovery and business continuity features if your EHR vendor supports those features. So, be sure to have a competent IT person look over the EHR vendors capabilities. Plus, you might want to put these capabilities in your EHR contract since they often say one thing about disaster recovery and then deliver another.

93. TRY to use a vendor that actually has standards in their system I find this point from Shawn interesting. My first problem with it is that unfortunately we don’t have great standards in healthcare IT (yet?). However, a few that are easily recognized are HL7 and CCR/CCD. I honestly can’t say I’ve seen any vendor that doesn’t support HL7 though. So, since they all do it, that won’t help you much.

The other side of this coin is the various systems that an EHR vendor uses. Do they use a standard SQL database and a common programming language or do they use a proprietary database and programming language? I’m not sure this should be a complete deal killer, but there is some benefit to choosing an EMR system that uses a standard SQL database. Particularly if we’re talking about a client server EMR system. However, for most people this won’t likely have much impact on them. The only exception being that the language and/or database they use might be an indication of how “legacy” their EHR software is.

92. Google “product name + support forum”
There’s some real value for an EHR vendor to have an online support forum. In some cases, EHR vendors have support forums that are run by a third party. I think we can all see the value in sharing experiences using a specific EHR software with someone else who uses that same software. A lot of learning can happen that way. You’ll be amazed at how creative some people are and how vastly different they might use the same software.

My only problem with some of these third party online forums is that it can often mean that the support from that EHR vendor isn’t very good. Why do I say this? Because if the EHR vendor support was better, people wouldn’t have had to turn to these third party forums to get support. You can usually see if this is the case by browsing the threads of the forum and see how many complain about not getting support from the vendor and so that’s why they found the online forum.

I wouldn’t say an online forum is absolutely essential for an EHR company, but if they have one you should know about it and see what it’s like before you buy.

91. Google “product name + Twitter / Facebook / etc…
It seems that I wouldn’t knock an EHR company as much as Shawn does when it comes to an EHR vendor’s presence on things like Twitter and Facebook. Shawn says that it could be a sign that they’re stuck in the past. While this could be true, it could also just mean that they’ve chosen other forms of marketing that fit their skills and abilities.

While I don’t necessarily count lack of social media presence as a huge minus, it can be a huge plus. Twitter has become a great way for me to get support. For some reason companies like to listen more when I broadcast my need in a public forum. So, EHR companies that listen on the likes of Twitter might be a benefit for you when you’re not getting the support you need. Plus, an EHR vendor’s Twitter, Facebook and blog can tell you a lot about the personality of an EHR company. Something that can be really important in your assessment of the company.

If you want to see my analysis of the other 101 EMR and EHR tips, I’ll be updating this page with my 101 EMR and EHR tips analysis. So, click on that link to see the other EMR tips.

101 Tips to Make Your EMR and EHR More Useful – EHR Tips 96-101

Posted on July 28, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Shawn Riley on HealthTechnica has collected a great list called 101 Tips to Make your EMR and EHR More Useful. I find lists like this really interesting and provide a great point of conversation. So, I’m planning to take the 101 ways, and over 10 or so blog posts, I’m going to cover each suggestion and where appropriate provide some commentary on the tip. I expect it will drive some really interesting conversation.

101. Trust, but verify
This is a fine suggestion. It’s a tough balance to achieve, because you want and need to have the trust of your EHR vendor, because once you’re ready to implement that EHR you’re likely going to ask them for help. Some of the help will be rather easy for them to support, but more often than not you might want to ask them for some pretty custom work to make the EHR work the way you want it to work for your clinic. So, you want to make sure that you have a good relationship with your EHR vendor.

However, that doesn’t mean there’s anything wrong with verifying what the EHR vendor and their salespeople are telling you. In fact, it would be a huge mistake not to verify. There are lots of open forums like this website where you can ask and verify a lot of what the EHR representatives are telling you. Also, visit other hospitals, healthcare centers, doctors etc. who have implemented an EHR from the same vendor.

100. Ask about the learning curve
Great suggestion! Although, I don’t think there’s much value asking the EHR vendor about the learning curve. Ok, maybe you can find a little value if you ask them on average how much training their users require to implement their EHR. However, the learning curve of an EHR goes far beyond the initial training. So, you should ask your EHR vendors existing users about the learning curve. Also, try to ask those doctors who have implemented in the last 3-6 months. It’s easy to forget how hard (or easy) it was to learn something when you did it a few years ago.

99. Ask what platforms are supported
Yes, most EMR software is very specific. You can actually find much of the breakout of which platforms various EHR companies support on this EHR and EMR Operating System Compatibility wiki page. Obviously, if you love your Apple products, then you’re going to need to be sure that your EHR platform supports it. Not to mention, the platforms an EHR vendor supports (or more likely doesn’t support) might be a sign of how well the EHR is at keeping up with the latest technological trends.

98. Look for long life and long term support
Switching EMRs is worse than implementing one in the first place. Sure, they usually go better than the initial implementation, but there’s nothing fun about switching EMR software. So, do what you can to ensure that the EHR that you choose is going to be around into the future. Otherwise, even if you don’t want to switch EHR software, you may be forced to do so. It’s not fun redesigning clinical processes for a new EHR.

97. How will your teams be educated on the EMR / EHR?
Yes, your whole team will need to be educated. Even if you have one person that’s educated on all the components and then trains the rest of your staff, each staff member is going to need training. There are even many EHR companies that offer unlimited training. It’s part of their sales pitch. Basically, they offer unlimited training as a way to show that they have to make the EHR really easy to use so that they don’t spend all their time training you.

Personally, I also like to do some up front training for the EHR implementation and then budget for some training a few weeks or a month down the road. You’ll be amazed how much more you learn and how much better questions you ask after having used the EHR for a few weeks or month.

96. Ensure audit logs are easy to get to and are comprehensive
I like to do this best by imagining 5 legal scenarios that you might need the EMR audit logs. Then, ask the EHR vendor to provide you the audit logs for those 5 scenarios so that you can see how it would look if you happen to need that information. This is even better if you can test drive the EHR software and try running the logs yourself.

There you have it. My commentary on the first 5 of 101 EMR and EHR tips. 10 more posts to go. If you want to see my analysis of the other 101 EMR and EHR tips, I’ll be updating this page with my 101 EMR and EHR tips analysis. So, click on that link to see the other 95.

EMR Education Requirements For Doctors A Mixed Blessing

Posted on June 15, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As many readers know, the state of Massachusetts will soon require doctors to prove that they’re at least minimally EMR-savvy. By the year 2015, doctors will need to be able to demonstrate that they’re competent in EMR use to maintain their license, and apparently, having CME credits in this area counts as “proficiency.”

While there’s no guarantee, my guess is that most or all of the other state governments will take a similar tack. After all, the federal government has thrown its weight behind EMR use and imposed standards (Meaningful Use) demanding that clinicians generate some value from their system.  If I were in state officials’ shoes, I’d want to get on the bandwagon before I was forced to adopt federal rules on this subject. (I’m also betting on the spread of the Mass approach simply because the state is a trend-setter.)

In theory, this is a good idea. Nobody wants to see themselves or someone they care about harmed because their doctor didn’t know how to enter data, where to click or whether they’re looking at the right allergy list, just to make up a few random issues. And while CME courses aren’t perfect, they can at least be standardized to make sure everyone’s at a known minimum level of expertise.

That being said, this approach has some drawbacks, none of which are trivial.

For one thing, I’d argue that doctors don’t need to be brilliant EMR users so much as skilled EMR thinkers. In other words, doctors need to know how to leverage their EMRs to improve patient health, to detect possible issues such as medication mix-ups and streamline clinical data sharing, not just get through a clinical interview screen compentently or figure out e-prescribing. If states are going to get involved with the EMR education process, why not go for higher-level training which can actually improve patient care over the long term?

Another concern I have is that while CME courses may provide excellent training in core EMR skillsets, there’s no such thing as a single “EMR system.”  With (depending on who you believe) anywhere from 300 to 1000+ EMRs on the market, physicians can’t possibly learn everything they need to know from a single course. While some may adapt to their own EMR’s idiosyncrasies faster, others with CME credit may develop a false sense of confidence or simply burn out when they find out how much more they need to learn.

Last but not least, I’d hate to see EMR training go down the pharma path. Right now, of course, pharmas arguably buy doctor loyalty by sponsoring CME courses lavishly.  If doctors need CMEs in EMR use to keep their license, big EMR vendors with fat wallets (or even the pharmas) will step in and pay for them, a process which could eventually hand the market to the best-funded rather than the most sophisticated EMR product.

Truthfully, my arguments are probably in vain. My prediction is that CME courses for EMR use will eventually be required here, there and everywhere in the U.S.  I’m just hoping that a more robust model for training doctors emerges; this one may shortchange everyone involved.

Top Three Annoying Things EHR Vendors Do To Sell

Posted on June 1, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The following is my personal list of pet peeves about the way vendors conduct themselves during the sales process. This comes from observation, not direct experience, as I’m a researcher rather than a techie — but I hear about these issues over and over.

Top Three Annoying Things EHR Vendors Do To Sell
(in no particular order):

1.   Can’t explain how their product actually solves physician problems:  Tech companies can’t help being a little, er, technical when they describe their products, and EHR firms are no exception. Too often, they end up writing their documentation to please their colleagues rather than their customers.  Others, meanwhile, entice customers with shallow nonsense (oh, and I mention spectacular, $200K boothes at HIMSS) then throw a confusing technical mess at buyers when they’re ready to look closer.

2.   Claim their product is a Swiss Army knife: Even the biggest, baddest enterprise EHR package will eventually need significant add-ons such as master data management technology.  Not only that, implementing any high-end EHR product will call for bridging technologies that integrate everything from labs to PACS.

3.  Slack off on support after the sale: Oh, this is a classic one for just about any software vendor, but it’s particularly damaging where EHRs are concerned.  Vendors often overpromise and under-deliver when it comes to tech support. The wise IT manager will evaluate what they need in the way of training and support, then make sure they get absolutely everything on the list.

I’ll be interested to see if you disagree with these, or come up with others. Just shoot me a note at katherine@emrandehr.com.

Providers Aren’t Taking EMR Training Seriously Enough

Posted on February 16, 2011 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As we noted in a previous post, the latest group of EMR buyers have gotten savvy about support.  As a new study suggests, more than ever, providers are choosing vendors who offer a great deal of handholding.  And that’s probably a good idea, according to Michael Patmas of the American College of Healthcare Executives.  Below,  here’s some of his thoughts on EMR and CPOE project failures.

I have had the unfortunate experience of being in two organizations that had EMR and / or CPOE implementation failures as well as one organization that was successful. A key learning for me was the need to adequately fund training and support. Too often, implementation plans are driven by the vendor who tend to under emphasize the training needs. Simply providing a few hours of hands on training for the physicians is not enough. The real training begins after one flips the switch and providers have to actually work with the system in real time during clinical encounters. That’s when having trainers available to sit with and coach the providers is essential. In every implementation failure I have seen, the organizations under-invested in training and ongoing support.

Sadly, though, many providers seem to cross  their fingers and hope a little training will somehow diffuse automatically into the organization.  This is a dangerously irresponsible stance, but it’s all too common.

In fact,  at three separate community hospitals, I’ve personally witnessed doctors and nurses huddled together over an EMR workstation trying to teach each other how to use the system.  If it made me squirm — under these circumstances, serious  errors like misdocumenting drug allergies are all but inevitable — hospital leaders should be terrified, shouldn’t they?